Giant Intracranial Aneurysms - Selective Endovascular Therapy By Coils

The authors present nine cases of giant aneurysm treated endovascularly by obliteration of the aneurysm lumen using platinum coils.Three aneurysms were located on the anterior circulation and six on the vertebrobasilar system. Presenting symptoms were mass effect in five cases and subarachnoid hemorrhage in four. Total occlusion of the aneurysms was achieved in four patients and partial occlusion in five. On follow-up (15 months), there was one repermeation and one neo-aneurysm. Both of these cases were retreated with placement of additional coils. All patients who presented with a mass effect had improvement of their symptoms (two after transient aggravation). Two patients died: one partially treated from hemorrhage, and the other from M.C.A. infarct after surgical clipping of the aneurysm.One technical complication included a lost coil which did not result in any angiographic or clinical change. One year follow-up angiographies show a permanent stable occlusion induced by coils.This technique should be considered as an option when treating giant non surgical aneurysm.